Free Bird Counseling and Consultation LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FREE BIRD COUNSELING AND CONSULTATION LLC

Practice address

1684 Selby Ave
Saint Paul, MN 55104-6149

Phone

(651) 206-8955

NPI assigned

Sep 18, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan J Bollinger-Brown, MSSW, LICSWNPI 1265500755

Title

Owner/Psychology

Phone

(651) 206-8955

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Free Bird Counseling and Consultation Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan J Bollinger-Brown, MSSW, LICSW, LCSW-C

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1265500755
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1194127456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 SELBY AVENUE",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551046149",
            "telephone_number": "651-206-8955",
            "fax_number": "651-389-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046149",
            "telephone_number": "651-206-8955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1684 Selby Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551046149",
            "country_code": "US",
            "telephone_number": "651-206-8955",
            "fax_number": "651-389-9397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "660 Mulberry Ln",
            "address_purpose": "LOCATION",
            "city": "Mendota Heights",
            "state": "MN",
            "postal_code": "551184313",
            "country_code": "US",
            "telephone_number": "651-206-8955",
            "fax_number": "651-389-9397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREE BIRD COUNSELING AND CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "BOLLINGER-BROWN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGY",
        "authorized_official_telephone_number": "651-206-8955",
        "authorized_official_credential": "MSSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1265500755",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165172200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Free Bird Counseling and Consultation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Free Bird Counseling and Consultation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Free Bird Counseling and Consultation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brent Curtis Fredrickson, DDS
• Laura Fredrickson
• Mary Fredrickson, M.D.
• Renee Fredrickson, PHD, L.P.
• Taylor Fredrickson, PA-C
• Veronica V. Freeberg
• Amanda Z Freed, L.AC.
• Matthew Freed
• Freedom Force
• Kathryn J Freeman, MD

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.